WO1989006517A1 - Medical catheter with cutting device - Google Patents

Medical catheter with cutting device Download PDF

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Publication number
WO1989006517A1
WO1989006517A1 PCT/EP1989/000054 EP8900054W WO8906517A1 WO 1989006517 A1 WO1989006517 A1 WO 1989006517A1 EP 8900054 W EP8900054 W EP 8900054W WO 8906517 A1 WO8906517 A1 WO 8906517A1
Authority
WO
WIPO (PCT)
Prior art keywords
hose
cutting tool
catheter according
tube
cutting
Prior art date
Application number
PCT/EP1989/000054
Other languages
German (de)
French (fr)
Inventor
Uwe Stocksmeier
Original Assignee
Uwe Stocksmeier
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Uwe Stocksmeier filed Critical Uwe Stocksmeier
Priority to DE8989902634T priority Critical patent/DE58900505D1/en
Publication of WO1989006517A1 publication Critical patent/WO1989006517A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00553—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated using a turbine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
    • A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements

Definitions

  • the invention relates to a medical catheter with cutting .
  • the device at the front end of a tube provided for insertion into blood vessels, the cutting device having a rotating cutting tool, the rotational diameter of which is smaller than the inner diameter of the tube and which can be displaced with respect to the tube in the direction of the axis of rotation.
  • Such a catheter is known from EP-A 0086 048.
  • the cutting device here consists of a milling head and a drive shaft which runs inside the hose, the milling head being arranged at the front end of the drive shaft and the latter being set in rotation by a motor arranged at the other end.
  • the catheter is used in such a way that the tube is first inserted into the vessel and pushed as far as the constriction to be removed, whereupon the cutting tool is then inserted into the tube and pushed through it until it emerges at the front end thereof and used to remove the vasoconstriction.
  • a catheter is also known, in which a cutting tool is provided in the manner of a milling cutter at the front end of the hose, which can be driven by means of a turbine coupled thereto.
  • the turbine is driven by means of a pressure fluid through a pressure line running inside the hose.
  • the hose is designed as a double hose, the hydraulic fluid and / or the removed tissue can be removed at the same time. Since the end of the tube and the cutting tool can only be advanced together with this catheter, the inner wall of the blood vessels is heavily used; In the case of largely closed blood vessels in particular, tissue displacement through the advancement of the tube end is unavoidable.
  • the present invention has for its object to design a generic catheter so that the risk of undesirable damage to the tissue is reduced.
  • This object is achieved in that the cutting device or only the cutting tool is mounted at the front end of the hose, such that the cutting tool between a retracted rest position defined by a first stop, in which it is completely accommodated inside the hose, and ' one extended, defined by a second stop working position, in which it is opposite the front end of the hose. protrudes more or less, is displaceable.
  • the cutting tool can be pushed slightly beyond the front end of the hose, so that a thrombus which closes the vessel completely or partially collapses and the front end of the hose continues to avoid squeezing and pressing in accordance with the processing of the thrombus
  • the blood vessel can be pushed in, that is, as the thrombus is worked through, the tube is retraced.
  • the cutting tool is nevertheless always held centrally by the front end of the hose so that it cannot injure the vessel walls.
  • the working position of the cutting tool is defined by a stop reliably prevents the vessel from being undesirably impaired by a cutting tool which protrudes too far.
  • the removal of the vasoconstriction is not only less dangerous than with known catheters, but can moreover also take place in a shorter time after the operation of the catheter is less precise and tolerates a less cautious approach by the operator without exposing the vessel to be treated to the risk of injury. Shortening the duration of treatment is a great advantage for both the patient and the treating doctor.
  • the safety in the operation of the catheter is further improved by the feature according to subclaim 3.
  • the rigid shaft reliably prevents the cutting tool, which is designed as a " cutting propeller", from deflecting sideways.
  • the fact that the cutting propeller works into a thrombus means that required space for feeding the hose end is always guaranteed.
  • This consideration is further supported by the feature of subclaim 2, according to which the design of the cutting propeller ensures that the material to be cut is quickly removed from the cutting parts in the direction of the interior of the hose.
  • This effect can be further improved by connecting the hose to a suction pump according to subclaim 5.
  • the protrusion of the cutting tool over the front end of the hose can be adjusted in the working position, which enables optimal adaptability to the respective application is.
  • the cutting tool provided according to the invention can also be used in combination with other devices that can be inserted into the vessels for the treatment of vascular diseases, for example devices for expanding vessels.
  • the possibilities known from the prior art are equally suitable for driving the cutting tool.
  • the drive can thus take place via a flexible drive shaft arranged in the interior of the hose; however, the cutting device can also comprise a turbine which is operated by means of a the hose supplied fluid is driven and is rotatably connected to the cutting tool.
  • the hose can be designed in a known manner as a double hose, the fluid serving to drive the turbine being supplied in one chamber, while being discharged in the other chamber. In this case, the cutting tool or the entire cutting device can be moved by changing the pressure conditions in the two chambers of the hose.
  • Fig. 1 shows a schematic axial section through a catheter according to the invention with mechanical drive of the cutting device
  • FIG. 2 shows a schematic axial section through a catheter according to the invention with hydraulic drive of the cutting device.
  • Fig. 1 shows a schematic axial section through the front end of the hose (1) one medical catheter, a cutting device (2) arranged in the interior of the tube end.
  • the cutting device C2) consists of a flexible drive shaft (12) which is rotatably mounted centrally in the hose (1) and which ends with a rigid shaft (3), at the free end of which a cutting tool (5) is attached via a hub (4) .
  • the cutting tool (5) has cutting edges (6) on its side facing away from the tube, the special shape and cutting properties of which result from the intended use of the catheter according to the invention.
  • the shaft (3) is mounted in a plain bearing (7) which is held centrally in a bushing (9) by means of spokes (8).
  • the socket (9) is fixed in the front end of the hose (1), which tapers slightly in its end section to reduce the risk of injury to the vessels and is rounded at its front end (10).
  • the cutting tool (5) is shown in its working position A, in which it projects slightly beyond the front end (10) of the hose (1).
  • the position of the cutting tool (5) in the working position A is predetermined in that the end of the cutting tool facing away from the Plain bearing (7) on a stop (11) forming the connection of the rigid shaft (3) with the flexible drive shaft (12).
  • the dashed lines show the cutting device in the rest position R, the position of which is defined in that the hub (4 ") of the cutting tool rests on the end of the sliding bearing (7) facing it.
  • the cutting tool (5) is designed propeller-shaped, so that the substance separated from the thrombus with the aid of the cutting edges (6) is conveyed into the interior of the hose by suction, from which it is sucked - for example by means of a pump (not shown) can.
  • FIG. 2 shows an alternative embodiment of the catheter according to the invention.
  • the cutting device is driven by means of a pressure medium supplied inside the hose.
  • an inner hose (13) is arranged in the hose (1), in which the pressure medium is directed from a pump (not shown) to a turbine (14), which is cut with the cutting tool (5) via the rigid shaft ( 3) is non-rotatably connected.
  • the end of the inner The hose (13) is held centrally in the bushing (9) by means of several guide plates (15).
  • the hub (16) of the turbine (14) forms the stop (11) which defines the working position (A) of the cutting tool (5).
  • the turbine is dimensioned so that it fills the clear width of the inner hose (13).
  • a baffle (17) is arranged between the bushing (9) and the slide bearing (7), which deflects the pressure medium leaving the turbine (14) and introduces it into the annular cavity between the hose (1) and the inner hose (13).
  • the turbine (14) is pressed with its hub (16) against the slide bearing (7) and thereby holds the cutting tool (5) in the working position (A) .
  • the protrusion of the cutting tool (5) over the front end of the hose (1) can be adjusted, for example, by replacing the hub (4) of the cutting tool and / or the rigid shaft (3) with corresponding parts, one of which have greater or smaller axial extension.

Abstract

A medical catheter has a rotary cutting tool (5) mounted at its front end so as to slide axially between an extended working position (A) and a retracted rest position (R).

Description

Medizinischer Katheter mit Schneidvorrichtung Medical catheter with cutting device
- 1 -- 1 -
Beschreibungdescription
Die Erfindung betrifft einen medizinischen Katheter mit Schnei.dvorrichtung am vorderen Ende eines zum Einführen in Blutgefäße vorgesehenen Schlauches, wobei die Schneidvorrichtung ein rotierendes Schneid¬ werkzeug aufweist, dessen Rotationsdurchmesser kleiner ist als der Innendurchmesser des Schlauches und welches bezüglich des Schlauches in Richtung der Rotationsachse verschiebbar ist.The invention relates to a medical catheter with cutting . The device at the front end of a tube provided for insertion into blood vessels, the cutting device having a rotating cutting tool, the rotational diameter of which is smaller than the inner diameter of the tube and which can be displaced with respect to the tube in the direction of the axis of rotation.
Ein derartiger Katheter ist aus der EP-A 0086 048 bekannt. Die Schneidvorrichtung besteht hier aus einem Fräskopf und einer Antriebswelle, welche im Inneren des Schlauches verläuft, wobei der Fräskopf am vorderen Ende der Antriebswelle angeordnet ist und letzere von einem am anderen Ende angeordneten Motor in Rotation versetzt wird. Die Benützung des Katheters erfolgt in der Weise, daß zunächst der Schlauch in das Gefäß eingeführt und bis zu der zu beseitigenden Verengung geschoben wird, woraufhin anschließend das Schneidwerkzeug in den Schlauch eingeführt und durch diesen hindurchgeschoben wird, bis es am vorderen Ende desselben wieder austritt und zum Entfernen der Gefäßverengung einge¬ setzt v/erden kann.Such a catheter is known from EP-A 0086 048. The cutting device here consists of a milling head and a drive shaft which runs inside the hose, the milling head being arranged at the front end of the drive shaft and the latter being set in rotation by a motor arranged at the other end. The catheter is used in such a way that the tube is first inserted into the vessel and pushed as far as the constriction to be removed, whereupon the cutting tool is then inserted into the tube and pushed through it until it emerges at the front end thereof and used to remove the vasoconstriction.
Bei diesem bekannten Katheter ist es nachteilig, daß die Position des Schneidwerkzeuges bezogen auf das vordere Ende des Schlauches während der Anwendung des Katheters nicht eindeutig bestimmbar ist, unter anderem deshalb, v/eil sich bei gekrümmtem Katheter die Antriebswelle und der Schlauch im Bereich der Krümmung gegeneinander verschieben. Ein zu weit gegenüber dem vorderen Ende des Schlauches vorgeschobenes Schneidwerkzeug kann jedoch unerwünschte Folgen verursachen, insbesondere das Gefäß verletzen.In this known catheter, it is disadvantageous that the position of the cutting tool relative to the front end of the tube during the The use of the catheter cannot be clearly determined, among other things, because the drive shaft and the tube move against one another in the region of the curvature when the catheter is curved. However, a cutting tool advanced too far in relation to the front end of the hose can cause undesirable consequences, in particular injure the vessel.
Aus der DE-A 33 20 076 ist ferner ein Katheter bekannt, bei dem am vorderen Ende des Schlauches ein Schne dwerkzeug in Art einer Fräse vorgesehen ist, welches mittels einer damit gekoppelten Turbine antreibbar ist. Die Turbine wird mittels einer Druckflüssigkeit durch eine im Inneren des Schlauches verlaufende Druckleitung angetrieben. Bei Ausführung des Schlauches als Doppelschlauch kann gleichzeitig für einen Abtransport der Druckflüssigkeit und/oder des entfernten Gewebes gesorgt v/erden. Da bei diesem Katheter Schlauchende und Schneidwerkzeug nur gemeinsam vorgeschoben werden können, wird die Innenwand der Blutgefäße stark in Anspruch genommen; insbesondere bei weitgehend verschlossenen Blutgefäßen ist eine Gewebeverdrängung durch den Vorschub des Schlauchendes unvermeidbar.From DE-A 33 20 076 a catheter is also known, in which a cutting tool is provided in the manner of a milling cutter at the front end of the hose, which can be driven by means of a turbine coupled thereto. The turbine is driven by means of a pressure fluid through a pressure line running inside the hose. If the hose is designed as a double hose, the hydraulic fluid and / or the removed tissue can be removed at the same time. Since the end of the tube and the cutting tool can only be advanced together with this catheter, the inner wall of the blood vessels is heavily used; In the case of largely closed blood vessels in particular, tissue displacement through the advancement of the tube end is unavoidable.
Der vorliegenden Erfindung liegt die Aufgabe zugrunde, einen gattungsgemäßen Katheter so auszubilden, daß die Gefahr einer unerwünschten Beschädigung des Gewebes verringert wird. Diese Aufgabe wird erfindungsgemäß dadurch gelöst, daß die Schneidvorrichtung oder nur das Schneidwerkzeug am vorderen Schlauchende gelagert ist, derart, daß das Schneidwerkzeug zwischen einer zurückgezogenen, durch einen ersten Anschlag definierten Ruhestellung, in welcher es vollständig im Inneren des Schlauches aufgenommen ist, und' einer ausgefahrenen, durch einen zweiten Anschlag definierten Arbeitsstellung, in welcher es gegenüber dem Stirnende des Schlauches. mehr oder weniger weit übersteht, verschiebbar ist.The present invention has for its object to design a generic catheter so that the risk of undesirable damage to the tissue is reduced. This object is achieved in that the cutting device or only the cutting tool is mounted at the front end of the hose, such that the cutting tool between a retracted rest position defined by a first stop, in which it is completely accommodated inside the hose, and ' one extended, defined by a second stop working position, in which it is opposite the front end of the hose. protrudes more or less, is displaceable.
Dabei besteht eine wesentliche Überlegung darin, daß das Schneidwerkzeug geringfügig über das vordere Schlauchende hinausgeschoben werden kann, so daß ein das Gefäß ganz oder teilweise verschließender Thrombus in sich zusammenfällt und das vordere Schlauchende unter Vermeidung von Quetschungen und Pressungen entsprechend der Abarbeitung des Thrombus weiter in das Blutgefäß hineingeschoben werden kann, das heißt, in dem Maße wie der Thrombus abgearbeitet wird, wird der Schlauch nachgefahren. Das Schneidwerkzeug ist trotzdem stets durch das vordere Schlauchende zentrisch gehalten, sodaß es die Gefäßwände nicht verletzen kann. Dadurch, daß die Arbeitsstellung des Schneidwerkzeuges durch einen Anschlag definiert ist, wird zuverlässig verhindert, daß das Gefäß durch ein zu weit vorstehen¬ des Schneidwerkzeug in unerwünschter Weise beeinträch¬ tigt wi d. Nachdem bei dem erfindungsgemäßen Katheter keine Gefahr besteht, daß die Schneidvorrichtung zu weit aus dem Schϊauch herausragt, ist die Entfernung der Gefäßverengung nicht nur weniger gefährlich als mit bekannten Kathetern, sondern kann darüberhinaus auch in kürzerer Zeit erfolgen, nachdem die Bedienung des Katheters eine geringere Präzision und ein weniger behutsames Vorgehen der Bedienungsperson toleriert, ohne daß dadurch das Zu behandelnde Gefäß der Gefahr einer Verletzung ausgesetzt würde. Eine Verkürzung der Behandlungsdauer ist sowohl für den Patienten wie für den behandelnden Arzt ein großer Vorteil.An important consideration here is that the cutting tool can be pushed slightly beyond the front end of the hose, so that a thrombus which closes the vessel completely or partially collapses and the front end of the hose continues to avoid squeezing and pressing in accordance with the processing of the thrombus The blood vessel can be pushed in, that is, as the thrombus is worked through, the tube is retraced. The cutting tool is nevertheless always held centrally by the front end of the hose so that it cannot injure the vessel walls. Thereby, the fact that the working position of the cutting tool is defined by a stop reliably prevents the vessel from being undesirably impaired by a cutting tool which protrudes too far. Since there is no danger in the catheter according to the invention that the cutting device protrudes too far from the tube, the removal of the vasoconstriction is not only less dangerous than with known catheters, but can moreover also take place in a shorter time after the operation of the catheter is less precise and tolerates a less cautious approach by the operator without exposing the vessel to be treated to the risk of injury. Shortening the duration of treatment is a great advantage for both the patient and the treating doctor.
Die Sicherheit bei der Bedienung des Katheters wird noch verbessert durch das Merkmal gemäß Unteran¬ spruch 3. Durch die starre Welle wird ein seitliches Ausweichen des als" Schneidpropeller ausgebildeten Schneidwerkzeugs zuverlässig vermieden. Dadurch, daß der Schneidpropeller sich zeπtrisch in einen Thrombus einarbeitet, ist der erforderliche Freiraum für den Vorschub des Schlauchendes stets gewährleistet. Diese Überlegung wird noch zusätzlich unterstützt durch das Merkmal von Unteranspruch 2, wonach schon durch die Ausbildung des Schneidpropellers dafür gesorgt ist, daß das Schneidgut zügig von der Schneid- steile in Richtung auf das Schlauchinnere abtranspor¬ tiert wird. Diese Wirkung kann noch weiter verbessert werden durch Anschließen des Schlauches an eine Saugpumpe gemäß Unteranspruch 5. Bei einer bevorzugten Ausführungsform des erfindungsgemäßen Katheters ist der Überstand des Schneidwerkzeuges über das vordere Ende des Schlauches in der Arbeitsstellung einstellbar, wodurch eine optimale Anpaßbarkeit an den jeweiligen Einsatzfall möglich ist. Selbstver¬ ständlich kann das erfindungsgemäß vorgesehene Schneidwerkzeug auch in Kombination mit anderen zur Behandlung von Gefäßkrankheiten in die Gefäße einführbaren Geräten, z.B. Vorrichtungen zum Aufweiten von Gefäßen, verwendet werden.The safety in the operation of the catheter is further improved by the feature according to subclaim 3. The rigid shaft reliably prevents the cutting tool, which is designed as a " cutting propeller", from deflecting sideways. The fact that the cutting propeller works into a thrombus means that required space for feeding the hose end is always guaranteed. This consideration is further supported by the feature of subclaim 2, according to which the design of the cutting propeller ensures that the material to be cut is quickly removed from the cutting parts in the direction of the interior of the hose. This effect can be further improved by connecting the hose to a suction pump according to subclaim 5. In a preferred embodiment of the catheter according to the invention, the protrusion of the cutting tool over the front end of the hose can be adjusted in the working position, which enables optimal adaptability to the respective application is. Of course, the cutting tool provided according to the invention can also be used in combination with other devices that can be inserted into the vessels for the treatment of vascular diseases, for example devices for expanding vessels.
Zum Antrieb des Schneidwerkzeuges kommen die aus dem Stand der Technik bekannten Möglichkeiten gleicher¬ maßen in Frage. Der Antrieb kann somit über eine im Schlauchinneren angeordnete, flexible Antriebswelle erfolgen; die Schneidvor.richtung kann aber auch eine Turbine umfassen, welche mittels eines durch den Schlauch zugeführten Fluids angetrieben wird und mit dem Schneidwerkzeug drehfest verbunden ist. Bei der .letztgenannten Ausführung kann in bekannter Weise der Schlauch als Doppelschlauch ausgebildet sein, wobei in der einen Kammer das dem Antrieb der Turbine dienende Fluid zugeführt wird, während es in der anderen Kammer abgeleitet wird. Die Verschiebung des Schneidwerkzeuges oder auch der gesamten Schneidvorrichtung kann in diesem Fall durch Veränderung der Druckverhältnisse in den beiden Kammern des Schlauches erfolgen.The possibilities known from the prior art are equally suitable for driving the cutting tool. The drive can thus take place via a flexible drive shaft arranged in the interior of the hose; however, the cutting device can also comprise a turbine which is operated by means of a the hose supplied fluid is driven and is rotatably connected to the cutting tool. In the last-mentioned embodiment, the hose can be designed in a known manner as a double hose, the fluid serving to drive the turbine being supplied in one chamber, while being discharged in the other chamber. In this case, the cutting tool or the entire cutting device can be moved by changing the pressure conditions in the two chambers of the hose.
Im folgenden werden zwei Ausführungsbeispiele deV Erfindung anhand der Zeichnung erl utert. Es zeigenTwo exemplary embodiments of the invention are explained below with reference to the drawing. Show it
Fig. 1 einen schematischen Axialschnitt durch einen erfindungsgemäßen Katheter mit mechanischem Antrieb der Schneidvorrichtung undFig. 1 shows a schematic axial section through a catheter according to the invention with mechanical drive of the cutting device and
Fig. 2 einen schematischen Axialschnitt durch einen erfindungsgemäßen Katheter mit hydraulischem Antrieb der Schneidvorrich- tuπg.2 shows a schematic axial section through a catheter according to the invention with hydraulic drive of the cutting device.
Fig. 1 zeigt in einem schematischen Axialschnitt durch das vordere Ende des Schlauches (1) eines medizinischen Katheters eine im Inneren des Schlauch¬ endes angeordnete Schneidvorrichtung (2). Die Schneid¬ vorrichtung C2) besteht aus einer zentrisch im Schlauch (1) drehbar gelagerten flexiblen Antriebswelle (12), die mit einer starren Welle (3) endet, an deren freiem Ende über eine Nabe (4) ein Schneidwerkzeug (5) angebracht ist. Das Schneidwerkzeug (5) trägt auf seiner dem Schlauch abgewandten Seite Schneidkanten (6), deren spezielle Form und Schneideigenschaften sich aus dem Verwendungszweck des erfindungsgemäßen Katheters ergeben. Die Welle (3) ist in einem Gleit¬ lager (7) gelagert, das mittels Speichen (8) zentrisch in einer Buchse (9) gehalten wird. Die Buchse (9) ist fest in dem vorderen Ende des Schlauches (1), der zur Verringerung von Verletzungsgefahren für die Gefäße in seinem Endabschnitt leicht konisch verjüngt und an seinem Stirnende (10) abgerundet ist, angebracht.Fig. 1 shows a schematic axial section through the front end of the hose (1) one medical catheter, a cutting device (2) arranged in the interior of the tube end. The cutting device C2) consists of a flexible drive shaft (12) which is rotatably mounted centrally in the hose (1) and which ends with a rigid shaft (3), at the free end of which a cutting tool (5) is attached via a hub (4) . The cutting tool (5) has cutting edges (6) on its side facing away from the tube, the special shape and cutting properties of which result from the intended use of the catheter according to the invention. The shaft (3) is mounted in a plain bearing (7) which is held centrally in a bushing (9) by means of spokes (8). The socket (9) is fixed in the front end of the hose (1), which tapers slightly in its end section to reduce the risk of injury to the vessels and is rounded at its front end (10).
In der Zeichnung ist das Schneidwerkzeug (5) in seiner Arbeitsstellung A dargestellt, in der es leicht über das Stirnende (10) des Schlauches (1) hinausragt. Die Position des Schneidwerkzeuges (5) in der Arbeitsstellung A ist dadurch vorgegeben, daß das dem Schneidwerkzeug abgewandte Ende des Gleitlagers (7) an einem die Verbindung der starren Welle (3) mit der flexiblen Antriebswelle (12) bildenden Anschlag (11) liegt.In the drawing, the cutting tool (5) is shown in its working position A, in which it projects slightly beyond the front end (10) of the hose (1). The position of the cutting tool (5) in the working position A is predetermined in that the end of the cutting tool facing away from the Plain bearing (7) on a stop (11) forming the connection of the rigid shaft (3) with the flexible drive shaft (12).
Die gestrichelten Linien zeigen die Schneidvorrichtung in der Ruhestellung R, deren Position dadurch definiert ist, daß die Nabe (4") des Schneidwerkzeuges an dem ihr zugewandten Ende des Gleitlagers (7) anliegt.The dashed lines show the cutting device in the rest position R, the position of which is defined in that the hub (4 ") of the cutting tool rests on the end of the sliding bearing (7) facing it.
Das Schneidwerkzeug (5) ist propellerför ig ausge¬ bildet, so daß die mit Hilfe der Schneidkanten (6)vom Thrombus getrennte Substanz durch einen Sog in das Schlauchinnere befördert wird, aus dem sie - zum Beispiel mittels einer nicht dargestellten Pumpe abgesaugt v/erden kann.The cutting tool (5) is designed propeller-shaped, so that the substance separated from the thrombus with the aid of the cutting edges (6) is conveyed into the interior of the hose by suction, from which it is sucked - for example by means of a pump (not shown) can.
In Fig. 2 ist eine alternative Ausführungsform des erfindungsgemäßen Katheters dargestellt. Bei ihr erfolgt der Antrieb der Schneidvorrichtung- mittels eines im Inneren des Schlauches zugeführten Druckmittels. Zu diesem Zweck ist in dem Schlauch (1) ein innerer Schlauch (13) angeordnet, in welchem das Druckmittel von einer (nicht dargestellten) Pumpe auf eine Turbine (14) geleitet wird, welche mit dem Schneidwerkzeug (5) über die starre Welle (3) drehfest verbunden ist. Das Ende des inneren Schlauches (13) ist mittels mehrerer Leitbleche (15) in der Buchse (9) zentrisch gehalten. Die Nabe (16) der Turbine (14) bildet den Anschlag (11), welcher die Arbeitsstellung (A) des Schneidwerk¬ zeuges (5) definiert. Die Turbine ist so bemessen, daß sie die lichte Weite des inneren Schlauches (13) ausfüllt.2 shows an alternative embodiment of the catheter according to the invention. The cutting device is driven by means of a pressure medium supplied inside the hose. For this purpose, an inner hose (13) is arranged in the hose (1), in which the pressure medium is directed from a pump (not shown) to a turbine (14), which is cut with the cutting tool (5) via the rigid shaft ( 3) is non-rotatably connected. The end of the inner The hose (13) is held centrally in the bushing (9) by means of several guide plates (15). The hub (16) of the turbine (14) forms the stop (11) which defines the working position (A) of the cutting tool (5). The turbine is dimensioned so that it fills the clear width of the inner hose (13).
Zwischen der Buchse (9) und dem Gleitlager (7) ist ein Umlenkblech (17) angeordnet, welches das die Turbine (14) verlassende Druckmittel umlenkt und in den ringförmigen Hohlraum zwischen dem Schlauch (1) und dem inneren Schlauch (13) einleitet. Bei der dargestellten Strömungsrichtung, d.h. der Zuführung des Druckmittels durch den inneren Schlauch (13) wird die Turbine (14) mit ihrer Nabe (16) gegen das Gleitlager (7) gedrückt und hält dadurch das Schneidwerkzeug (5) in der Arbeitsstellung (A). Bei Umkehrung der Strömungsverhältnisse, d.h. Zuleitung des Druckmediums durch den ringförmigen Hohlraum zv/isehen dem Schlauch (1) und dem inneren Schlauch (13) wird die Turbine (14) durch das Druckmedium nach rechts bewegt und verschiebt dadurch das Schneid¬ werkzeug (5) in seine Ruhestellung (R), in der dessen Nabe (4) an dem Gleitlager (7) anliegt. A baffle (17) is arranged between the bushing (9) and the slide bearing (7), which deflects the pressure medium leaving the turbine (14) and introduces it into the annular cavity between the hose (1) and the inner hose (13). In the direction of flow shown, ie the supply of the pressure medium through the inner hose (13), the turbine (14) is pressed with its hub (16) against the slide bearing (7) and thereby holds the cutting tool (5) in the working position (A) . When the flow conditions are reversed, ie supply of the pressure medium through the annular cavity between the hose (1) and the inner hose (13), the turbine (14) is moved to the right by the pressure medium and thereby shifts the cutting tool (5) in its rest position (R), in which its hub (4) rests on the slide bearing (7).
Der Überstand des Schneidwerkzeuges (5) über das vordere Ende des Schlauches (1) l ßt sich beispiels¬ weise dadurch einstellen, daß die Nabe (4) des Schneidwerkzeuges und/oder die starre Welle (3) gegen entsprechende Teile ausgetauscht werden, die eine größere oder kleinere axiale Erstreckung besitzen. The protrusion of the cutting tool (5) over the front end of the hose (1) can be adjusted, for example, by replacing the hub (4) of the cutting tool and / or the rigid shaft (3) with corresponding parts, one of which have greater or smaller axial extension.

Claims

Patentansprüche Claims
Medizinischer Katheter mit Schneidvorrichtung (2) am vorderen Ende eines zum Einführen in Blutgefäße vorgesehenen Schlauches (1), wobei die Schneid¬ vorrichtung (2) ein rotierendes Schneidwerkzeug (5) aufweist, dessen Rotationsdurchmesser kleiner ist als der Innendurchmesser des Schlauches (1), und welches bezüglich des Schlauches (1) in Richtung der Rotationsachse verschiebbar ist, dadurch gekennzeichnet, daß die Schneidvorrichtung (2) oder nur das Schneidwerkzeug (5) am vorderen Schlauchende gelagert ist, derart, daß das Schneidwerkzeug (5) zwischen einer zurückgezogenen, durch einen ersten Anschlag definierten Ruhestellung (R), in welcher es vollständig im Inneren des Schlauch¬ endes aufgenommen ist, und einer ausgefahrenen, durch einen zweiten Anschlag definierten Arbeits¬ stellung (A), in welcher es gegenüber dem Stirnende des Schlauches (1) mehr oder weniger weit übersteht, verschiebbar ist. --72.Medical catheter with a cutting device (2) at the front end of a tube (1) provided for insertion into blood vessels, the cutting device (2) having a rotating cutting tool (5) whose diameter of rotation is smaller than the inside diameter of the tube (1), and which is displaceable with respect to the hose (1) in the direction of the axis of rotation, characterized in that the cutting device (2) or only the cutting tool (5) is mounted on the front end of the hose, such that the cutting tool (5) between a retracted through a first stop defined rest position (R), in which it is received completely inside the hose end, and an extended work position (A) defined by a second stop, in which it is more opposite the front end of the hose (1) or less protrudes, is displaceable. --72.
2. Katheter nach Anspruch 1, dadurch gekennzeichnet, daß das Schneidwerkzeug (5) in Art eines Schneid¬ propellers ausgebildet ist, dessen Schaufeln Schneidkanten (6) aufweisen und zum Erzeugen eines in Richtung auf das Schlauchende gerichteten Soges geeignet ausgebildet sind.2. Catheter according to claim 1, characterized in that the cutting tool (5) is designed in the manner of a Schneid¬ propeller, the blades of which have cutting edges (6) and are suitable for generating a suction directed towards the hose end.
3. Katheter nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß das Schneidwerkzeug (5) über eine im Schlauch¬ inneren verlaufende flexible Antriebswelle (12) angetrieben ist und daß ein kurzer an das Schneid¬ werkzeug anschließender Abschnitt der Antriebswelle zum Zwecke der längsverschieblichen Lagerung" des Schneidwerkzeugs (5) als starre Welle (3) ausgebildet ist.3. Catheter according to claim 1 or 2, characterized in that the cutting tool (5) is driven via a flexible drive shaft (12) extending inside the tube and that a short section of the drive shaft adjoining the cutting tool is used for the purpose of longitudinally displaceable mounting "of the cutting tool (5) is designed as a rigid shaft (3).
4. Katheter nach Anspruch 3, dadurch gekennzeichnet, daß das Schneidwerkzeug (5) fliegend am Ende der starren Welle (3) befestigt ist, welche in einem Gleitlager gelagert ist, das im Zentrum einer das Schia'uchende von innen auskleidenden Buchse (9) angeordnet und mit dieser über wenige Speichen (8) verbunden ist. * ~4. Catheter according to claim 3, characterized in that the cutting tool (5) is attached to the end of the rigid shaft (3), which is mounted in a slide bearing which is located in the center of a sleeve (9) lining the Schia ' looking for. arranged and connected to it via a few spokes (8). * ~
5. Katheter nach Anspruch 1, gekennzeichnet dadurch , daß der Schlauch (1) als Saugschlauch ausgebildet und an eine Saugpumpe anschließbar ist.5. Catheter according to claim 1, characterized in that the hose (1) is designed as a suction hose and can be connected to a suction pump.
6. Katheter nach Anspruch 1, dadurch gekennzeichnet, daß der Überstand"des Schneidwerkzeuges (5) über das vordere Ende des Schlauches (1) in der Arbeitsstellung (A) einstellbar ist.6. Catheter according to claim 1, characterized in that the protrusion "of the cutting tool (5) over the front end of the tube (1) in the working position (A) is adjustable.
7. Katheter nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß die Schneidvorrichtung (2) eine Turbine umfaßt, welche mittels eines durch den Schlauch (1) zugeführten Druckmittel angetrieben wird und mit dem Schneidwerkzeug (5) drehfest verbunden ist.7. Catheter according to claim 1 or 2, characterized in that the cutting device (2) comprises a turbine which is driven by means of a pressure medium supplied through the hose (1) and is connected in a rotationally fixed manner to the cutting tool (5).
8. Katheter nach Anspruch 7, dadurch gekennzeichnet, daß die gesamte Schneidvorrichtung (2) bezüglich des Schlauches CD axial verschiebbar ist. 8. Catheter according to claim 7, characterized in that the entire cutting device (2) is axially displaceable with respect to the tube CD.
1Y1Y
9. Katheter nach Anspruch 8, dadurch gekennzeichnet, daß der Schlauch zwei Kammern enthält, von denen eine der Zuführung und die andere der Rückführung des Druckmittels dient, und daß die Verschiebung der Schneidvorrichtung dadurch erfolgt, daß die Strömungsverhältnisse des Druckmittels umgekehrt werden. 9. A catheter according to claim 8, characterized in that the tube contains two chambers, one of which serves for the supply and the other for the return of the pressure medium, and in that the displacement of the cutting device takes place in that the flow conditions of the pressure medium are reversed.
PCT/EP1989/000054 1988-01-19 1989-01-18 Medical catheter with cutting device WO1989006517A1 (en)

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Application Number Priority Date Filing Date Title
DE8989902634T DE58900505D1 (en) 1988-01-19 1989-01-18 MEDICAL CATHETER WITH CUTTER.

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DE3801318A DE3801318A1 (en) 1988-01-19 1988-01-19 MEDICAL CATHETER WITH CUTTER
DEP3801318.5 1988-01-19

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EP (1) EP0407400B1 (en)
JP (1) JP2665012B2 (en)
DE (3) DE3801318A1 (en)
WO (1) WO1989006517A1 (en)

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Also Published As

Publication number Publication date
JP2665012B2 (en) 1997-10-22
DE3801318A1 (en) 1989-07-27
EP0407400B1 (en) 1991-11-27
EP0407400A1 (en) 1991-01-16
DE8904260U1 (en) 1989-06-29
JPH03503492A (en) 1991-08-08
US5195956A (en) 1993-03-23
DE58900505D1 (en) 1992-01-09

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